- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.65 / $732.06 / $74,999.25
| Facility | | $391.65 | $732.06 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $252.56 / $296.48 / $303.80
| Professional | | $252.56 | $296.48 | $303.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.13 / $547.41 / $867.17
| Facility | | $144.13 | $547.41 | $867.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.52 / $254.89 / $508.18
| Professional | | $248.52 | $254.89 | $508.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $311.13 / $311.13 / $311.13
| Facility | | $311.13 | $311.13 | $311.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.13 / $311.13 / $311.13
| Professional | | $311.13 | $311.13 | $311.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $290.67 / $352.14 / $630.75
| Facility | | $290.67 | $352.14 | $630.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.02 / $305.02 / $1,274.44
| Professional | | $305.02 | $305.02 | $1,274.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.02 / $305.02 / $305.02
| Professional | | $305.02 | $305.02 | $305.02 |